House panel inquires on failed HHS cyber center

FIRST IN MORNING EHEALTH: E&C SEEKS INFO ON HHS CYBER CENTER ALLEGATIONS: The House Energy and Commerce Committee is concerned about the controversy surrounding the Healthcare Cybersecurity Communications and Integration Center, and wrote Tuesday night to HHS asking why the center’s two leaders were sidelined. As first reported by Morning eHealth’s Darius Tahir on Monday, the center has been paralyzed since the summer over dueling allegations of misconduct: HHS is investigating claims the two leaders committed improprieties in contracts to build the fledging center, while the two claim they’re the targets of a smear campaign by private-sector actors and enemies within HHS.

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The committee, the letter to HHS states, has been meeting with the two executives about their whistleblowing charges. While “at a preliminary stage,” the committee’s “working assumption” is that the allegations are credible. The committee is seeking briefings by Nov. 28 about the dismissals and the policy work related to the cyber center, as well as documents related to the investigation.

ADDICTION DOC TAKES MATTER INTO OWN HANDS: As Washington drags its feet on addressing the nation’s opioid epidemic, a halfway house in the Appalachian foothills has defied federal law. It’s either that or watch patients die. A 2007 federal law — aimed at giving the Drug Enforcement Administration more power to crack down on illegal online drug sales — outlawed prescribing controlled substances, including anti-addiction meds like Suboxone, before an in-person visit. But an addiction psychiatrist at the University of Maryland in Baltimore sees patients weekly at the Wells House, a 100-bed halfway house in Hagerstown, Md., through telemedicine from 70 miles away. "As physicians, we take the Hippocratic oath to help people," said Eric Weintraub. "We felt like we had to get involved."

More from my visit to Hagerstown: “In fact, Congress authorized the DEA a decade ago to create a waiver for doctors like Weintraub to provide addiction care through telemedicine. The DEA, however, has dithered. Trump hasn't even nominated someone to head the agency.”

Weintraub has data showing about 60 percent of his patients stay through the program at least three months, and only six percent test positive for illicit opioids after the first three months of treatment. About 80 patients at Wells House currently see Weintraub through telemedicine; the program has treated about 300 patients to date.

NET NEUTRALITY 101: The long-running fight over net neutrality, which pits telecom giants against tech companies, is heating up at the Federal Communications Commission. To understand what the fight is all about and where it’s headed, check out POLITICO’s latest explainer video featuring technology reporter Margaret Harding McGill and the artwork of Pulitzer Prize-winning cartoonist Matt Wuerker. Click HERE to watch.

SHULKIN ON THE STAND: The House Appropriations subcommittee on military construction and veterans affairs will get an update on the delayed VA-Cerner contract this morning. Secretary David Shulkin and John Windom, who leads the VA project office that’s cutting the deal with Cerner, are on the stand with Scott Blackburn from the VA Office of Information and Technology. The contract was supposed to have been signed by Oct. 6, but well-placed sources say it won’t happen until December now. Most of the VA’s requirements for the deal are finished, one source says, but congressional funding issues are causing some delays. We hear that an initial price tag of around $10 billion is likely, not including expected add-ons and other costs that could jack the eventual cost closer to $16 billion -$18 billion.

DOCTOR GROUPS URGE CMS ACTION ON UDIs: A dozen health care provider organizations, including the American College of Cardiology and American Medical Group Association, are urging CMS Administrator Seema Verma to add a field for unique device identifiers to Medicare claims forms. The additional data point, which the Trump administration has backtracked on after a commitment from the Obama regime, would benefit patient safety. “We do not believe this would introduce an undue burden,” their letter states. The letter.

INSIGHT INTO ONC’S WORK ON INFO BLOCKING: In ONC’s work to define what isn’t “information blocking” for 21st Century Cures, HHS’s health IT office is trying to figure out what health data needs to be shared and how that could be supported, ONC head Don Rucker said on The Cerner Podcast. “Rather than working from the negative, we’re trying to work from the positive,” the former Siemens executive said. Cures defines data access as sharing “without special effort,” but lawmakers pressed ONC earlier this month on when it would take a stance on several Cures mandates the office has yet to address. “We want to be careful with this that we’re really truly sharing data as opposed to creating isolated pools of data that actually have a lot of paywall barriers,” Rucker said.

‘PENDULUM HAS SWUNG’ ON TELEMEDICINE: Three-quarters of health care organizations currently offer or plan to offer telemedicine services this year, according to a new telemedicine and digital health survey from law firm Foley & Lardner. That’s significant because in 2014, 87 percent of respondents did not expect their patients to be using telemedicine services by this time. Read the full report.

“The pendulum has swung to really embrace telemedicine, which wasn’t close to being adopted and implemented on this scale when the respondents were first surveyed in 2014,” said Nathaniel M. Lacktman, chair of the firm’s Telemedicine Industry Team and co-chair of the firm’s Digital Health Work Group.

OPEN NOTES CONCEPT GAINS PROVIDER BACKING: Research published in the Annals of Internal Medicine found a broad range of 29 health care experts supported the idea of patients editing their medical notes, particularly before scheduled visits. “With some important cautions, they believed that co-production of records could improve patients' and clinicians' experiences with care and perhaps improve health care value,” John Mafi at UCLA and colleagues at Beth Israel Deaconess concluded.

—The finding “undoubtedly represents a step forward toward more patient-centered care,” Monika Safford of Weill Cornell Medicine wrote in an accompanying editorial. “Time and further research will tell us whether co-produced notes actually improve adherence and lower costs.”

Eric Topol even weighed in on Twitter: “Patients should be entitled to edit their notes. Period,” he tweeted.

AMA WANTS UPDATED REIMBURSEMENT PROCESS FOR GENOMICS: The American Medical Association would like an updated reimbursement process for genomics. Following a report from two of the association’s councils, physicians gathered Tuesday at the group’s interim meeting voted to approve new recommendations on reimbursement of genomic tests. The report argues that, with new genomic tests making it to market every day — and with tests for specific genes being integrated into multi-gene tests — it’s harder to sustain a reimbursement policy requiring old-school randomized controlled trials. Therefore, the system will have to develop new methods of assessing the effectiveness of such tests. The association’s new policy also argues for increased transparency in reimbursement decisions.

—Early at the AMA meeting, CEO James Madara outlined the group’s Integrated Health Model Initiative, which will assemble data elements into a “meaningful conceptualization of the patient’s state.” His speech and accompanying story.

GAO: TELEMEDICINE USE BY DoD FAIRLY NARROW: Less than one percent of the military’s 1.2 million active duty service members received a telemedicine visit last year, a GAO report out Tuesday found. The vast majority of these visits were real-time interactions, as opposed to sending images or data to be read by other doctors. Seven military hospitals provided almost all — 97 percent — of the telemedicine visits. About three-quarters of the military’s 59,000 telemedicine visits last year went to active duty service members. The GAO report was mandated by last year’s Defense reauthorization bill. The full report.

MEA CULPA: eCQMS ARE HERE TO STAY:Two weeks ago in Morning eHealth, we said goodbye to electronic clinical quality measures, following a CMS listserv announcement about its new Clinical Quality Language. But eCQMs aren’t going anywhere, CMS wants us to make clear. The technical language that makes up the measures — basically instructions for EHR vendors around timing and clinical interactions — is changing to become Clinical Quality Language. As we said before, CMS will publish the new standards in the spring for changes to hit in 2019. Who said health care was simple?

HAPPENING TODAY:

9:30 a.m. – House Appropriations Committee hearing on the VA’s new EHR, Room 2362-A Rayburn House Office Building

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About The Author

David Pittman is an eHealth reporter for POLITICO Pro.

Before joining POLITICO in May 2014, Pittman served as the lone Washington reporter for the health news website MedPage Today, covering nearly all aspects of health policy from Medicare and Medicaid to the Affordable Care Act and Capitol Hill. He has also covered science and regulatory policy for trade newsletter company FDAnews and the weekly newsmagazine Chemical & Engineering News. Pittman got his start in journalism covering healthcare for the daily newspaper in the West Texas town of Amarillo.

Pittman holds bachelor's degrees in journalism and chemistry from the University of Georgia, where he graduated in 2006. While in Athens, Pittman worked as a staff writer of The Red & Black and eventually became editor-in-chief, pestering school administrators. Like any good Southerner, he prefers his tea sweet, chicken fried and fall Saturdays reserved for college football. He is also surviving as an Atlanta Braves fan in a town full of Washington Nationals supporters.